Background: Earlier studies have shown that men infected with HIV-1 and a CD4+ cell count below 200 mm3 are at increased risk for bacteriuria. We studied the effect of 3 Pneumocystis carinii (PCP) prophylaxis regimens (low-dose TMP/SMZ, high-dose TMP/SMZ and pentamidine aerosol) on the incidence of bacteriuria and resistance development to TMP/SMZ.
Methods: Retrospective analysis of 103 HIV-positive patients.
Results: Nine patients using pentamidine had a positive culture (32%), compared to 9 patients using low-dose TMP/SMZ (17%) and 5 patients using high-dose TMP/SMZ (22%). These differences were not significant (P = 0.207). However, almost all episodes in patients using TMP/SMZ were due to infection with a resistant strain.
Conclusion: PCP prophylaxis with trimethoprim/sulfamethoxazole does not significantly influence the rate of bacteriuria, probably due to the development of resistance.